title: Stigma, sexual risk and desire for HIV tests in Ghana.
abstract: BACKGROUND
  Although various HIV prevention and treatment programs have been implemented in Ghana since 2003, desire for and uptake of HIV testing is still low, owing largely to HIV-related stigma. This study examined the effect of stigma on desire for HIV testing, while controlling for socio-demographic and other influences.
  
  
  METHODS
  The study used data from the 2003 Ghana Demographic and Health Survey to regress desire for an HIV test on levels of stigma while controlling for selected socio-demographic, socio-cognitive and socio-behavioural covariates.
  
  
  RESULTS
  The study revealed significant associations between several socio-demographic and socio-cognitive variables and the desire for an HIV test. For example, both male (adjusted odds ratio (AOR) = 0.41; 95% confidence interval (CI) = 0.24-0.72) and female (AOR = 0.62; 95% CI = 0.41-0.93) respondents in the wealthiest households, and those who know someone infected with HIV (AOR = 0.65; 95% CI = 0.43-1.00) have lower odds of desiring an HIV test. The study showed a significant but negative interaction between risky sexual behaviours and community stigma (AOR = 0.44; 95% CI = 0.19-0.67), indicating that the positive effect of risky sex on HIV testing is attenuated among females who live in communities with high levels of stigma.
  
  
  CONCLUSIONS
  Since community-level education and risk reduction programs have demonstrable influences on reducing HIV stigma, it is imperative that the Ghana government's ongoing anti-stigma campaigns and other HIV prevention programs recognise the role of community stigma in influencing HIV testing decisions, especially in the context of risky sexual behaviours.
authors.affiliation: Department of Culture and Communication, Drexel University, Philadelphia, PA 19104, USA. emmanuelkoku@drexel.edu
authors.forename: Emmanuel F
authors.initials: EF
authors.lastname: Koku
mesh_terms: D000293:Adolescent; D000328:Adult; D016001:Confidence Intervals; D005260:Female; D005869:Ghana / Q000453:epidemiology; D015658:HIV Infections / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011788:Quality of Life; D040242:Risk Reduction Behavior; D013240:Stereotyping; D011795:Surveys and Questionnaires; D055815:Young Adult